title: Facial exercise therapy for facial palsy: systematic review and meta-analysis.
abstract: The effectiveness of facial exercises therapy for facial palsy has been debated in systematic reviews but its effects are still not totally explained.
  
  
  OBJECTIVE
  To perform a systematic review with meta-analysis to evaluate the effects of facial exercise therapy for facial palsy.
  
  
  METHODS
  A search was performed in the following databases: Cochrane Controlled Trials Register Library, Cochrane Disease Group Trials Register, MEDLINE, EMBASE, LILACS, PEDro, Scielo and DARE from 1966 to 2010; the following keywords were used: 'idiopathic facial palsy', 'facial paralysis', 'Bell's palsy', 'physical therapy', 'exercise movement techniques', 'facial exercises', 'mime therapy' 'facial expression', 'massage' and 'randomized controlled trials'.
  
  
  METHODS
  The inclusion criteria were studies with facial exercises, associated or not with mirror biofeedback, to treat facial palsy.
  
  
  RESULTS
  One hundred and thirty-two studies were found but only six met the inclusion criteria. All the studies were evaluated by two independent reviewers, following the recommendations of Cochrane Collaboration Handbook for assessment of risk of bias (kappa coefficient = 0.8). Only one study presented sufficient data to perform the meta-analysis, and significant improvements in functionality was found for the experimental group (standardized mean difference (SMD) = 13.90; 95% confidence interval (CI) 4.31, 23.49; P = 0.005).
  
  
  CONCLUSIONS
  Facial exercise therapy is effective for facial palsy for the outcome functionality.
authors.affiliation: 1MSc Programme in Physical Education, Universidade Estadual de Londrina-UEM, Londrina, Brazil.
authors.forename: L M
authors.initials: LM
authors.lastname: Pereira
authors.forename: K
authors.initials: K
authors.lastname: Obara
authors.forename: J M
authors.initials: JM
authors.lastname: Dias
authors.forename: M O
authors.initials: MO
authors.lastname: Menacho
authors.forename: E L
authors.initials: EL
authors.lastname: Lavado
authors.forename: J R
authors.initials: JR
authors.lastname: Cardoso
mesh_terms: D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D005158:Facial Paralysis / Q000175:diagnosis / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome